Shiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071640620150921Evaluation of the Efficacy of Topical Ethyl Vanillate in Enhancing the Effect of Narrow Band Ultraviolet B against Vitiligo: A Double Blind Randomized, Placebo-Controlled Clinical Trial478484ENMohammad RezaNamaziMolecular Dermatology Research Center, Department of Dermatology, Shiraz University of Medical Sciences, Shiraz, Iran. namazi_mr@yahoo.comAmirKalafi Shotorbani2013111020140423Background: Vitiligo is an acquired disease of skin that presents with depigmented patches due to lack of melanocytes in the epidermis. Accumulation of toxic free radicals like hydrogen peroxide in the epidermis may be responsible for melanocytes death. Since ethyl vanillate (vanillic acid ethyl ester) is a strong hydrogen peroxide scavenger, it may be effective against vitiligo. This study was carried out to evaluate the effect of ethyl vanillate cream on vitiligo patients receiving phototherapy.Methods: A double-blind placebo-controlled clinical trial using ethyl vanillate cream 20% was performed on 30 cases of generalized stable vitiligo (randomly selected) who were receiving phototherapy in the outpatient clinic of Faghihi Hospital (Shiraz, Iran). The patients randomly applied ethyl vanillate on an assigned lesion (left or right side of the body) and placebo on the opposite side lesion (almost the same size and location) twice a day for 3 months, while receiving a narrow band ultraviolet B (NB-UVB) 2-3 times weekly. Photos were taken at the beginning of the trial and at the end of 4th, 8th, and 12th weeks. Then, images were compared with the photos from the beginning of the trial based on VASI score.Results: There was a significant change in pigmentation after applying ethyl vanillate compared with baseline in medication side (P=0.002), but no significant change in placebo side (P=0.066). Additionally, there was a significant difference between medication and placebo sides in pigmentation (P=0.005).Conclusion: Ethyl vanillate may serve as an adjunct therapy for the treatment of vitiligo, although changes in pigmentation are mild clinically.Keywords: Vitiligo, Vanillic Acid, PhototherapyShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071640620150921Early Acute Kidney Injury based on Serum Creatinine or Cystatin C in Intensive Care Unit after Major Trauma485492ENFaridZandShiraz Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. zandf@sums.ac.irGolnarSabetianGhasemAbbasiAbbasRezaianzadehAlirezaSalehiAbbasKhosraviBitaGeramizadehShuja UlhaqTareghShohrehJavadpour2015092120150923Background: Acute kidney injury (AKI) is a common problem in critically ill patients and is independently associated with increased morbidity and mortality. Recently, serum cystatin C has been shown to be superior to creatinine in early detection of renal function impairment. We compared estimated GFR based on serum cystatin C with estimated GFR based on serum creatinine for early detection of renal dysfunction according to the RIFLE criteria.Methods: During 9 months, three hundred post trauma patients that were referred to the intensive care unit of a referral trauma hospital were recruited. Serum creatinine and serum cystatin C were measured and the estimated GFR within 24 hours of ICU admission was calculated. The primary outcome was the incidence of AKI according to the RIFLE criteria within 2nd to 7th day of admission.Results: During the first week of ICU admission,21% of patients experienced AKI. After adjusting for major confounders, only the patients with first day's serum cystatin level higher than 0.78 mg/l were at higher risk of first week AKI (OR=6.14, 95% CI: 2.5-14.7, P&lt;0.001). First day’s serum cystatin C and injury severity score were the major risk factors for ICU mortality (OR=3.54, 95% CI: 1.7-7.4, P=0.001) and (OR=4.6, 95% CI: 1.5-14, P=0.007), respectively.Conclusion: Within 24 hours after admission in ICU due to multiple trauma, high serum cystatin C level may have prognostic value in predicting early AKI and mortality during ICU admission. However, such correlation was not seen neither with creatinine nor cystatin C based GFR.Keywords: Acute kidney injury, Trauma, Cystatin C, Creatinine, Glomerular filtration rateShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071640620150928No Definite Association between Human Parvovirus B19 Infection and Behçet Disease493500ENMojtabaHabibagahiDepartment of Immunology
School of Medicine
Shiraz University of Medical Sciences. agahim@sums.ac.irZahraHabibagahiSaid-MostafaSaidmardaniFaezehSadeghian2013100720140423Background: The etiology of the Behçet disease (BD) has remained obscured. There have been studies to show the association of BD to infections like herpes simplex, hepatitis, and parvovirus B19 however, the findings are rather controversial.Materials and Methods: We selected 55 patients with the best matched symptoms of BD and measured the loads of B19 DNA in their plasma by quantitative real time PCR and verified their seropositivity by ELISA. All findings were compared to the results from 42 healthy persons.Results: Patients showed a wide spectrum of BD symptoms. Serologic studies showed high prevalence of B19 IgG among the tested patients which was not statistically different with the healthy population (72.7% vs. 85.7%, respectively). Similarly, the prevalence of B19 IgM between patients and controls was not different (18% vs. 11.9%, respectively). No correlation was found between the presence of anti-B19 antibodies and the clinical observations. Only one person from the patient and control groups had detectable levels of B19 DNA without any difference or correlation with the disease symptoms.Conclusion: Our data could not establish an association between B19 parvovirus infection and Behçet disease, although there have been reports of such correlation. Nevertheless, there might be indirect relation in genetically susceptible individuals after viral infections. More studies on designed animal models and surveys on patients should be done to resolve this controversy.Shiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071640620150928Inhibitory Effects of Silver Nanoparticles on Growth and Aflatoxin B1 Production by Aspergillus Parasiticus501506ENSeyyed AminAyatollahi MousaviDepartment of Medical Mycology and Parasitology, School of Medicine, Kerman University of Medical Science, Kerman, Iran. aminayatollahi@kmu.ac.irSomayyehPourtalebi2013090120140423Background: Aflatoxins (AFs) are secondary hazardous fungal metabolites that are produced by strains of some Aspergillus species on food and feedstuffs. Aflatoxin B1 (AFB1) is one of the most important AF with high toxicity. Prevention of AF production and their elimination from food products is a matter of importance for many researchers in the last decades.Nanomaterials applications in medical science have been widely studied in the recent years. Most of existing researches seek the effect of nanoparticles on bacteria, fungi, and viruses. The aim of this study was to determine the effects of silver nanoparticles (AgNPs) on growth and AFB1 production of AF-producing Aspergillus parasiticus.Methods: A parasiticus was inoculated (106 conidia per ml of medium) to potato dextrose broth (PDB) medium and then AgNPs was added and incubated with shaking at 130 rpm and 28°C for 7 days. AF was assayed by high performance liquid chromatography (HPLC). Microbiological assay (MBA) on microplates contained potato dextrose broth (PDB) medium (4 days at 28°C) at different concentrations of AgNPs (60, 80, 100, 120, 140, 160, 180 and 200 μg/ml) was measured.Results: The results demonstrated that a minimum inhibition concentration (MIC) equal to 180 μg/ml was determined for AgNPs against A. parasiticus. The AgNPs effectively inhibited AFB1 production at a concentration of 90 μg/ml.Conclusion: The results obtained in this study show AgNPs at concentrations lower than the MIC drastically inhibited production of AFB1 by A. parasiticus in culture medium. The AgNPs may be useful to control AF contamination of susceptible crops in the field.Shiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071640620150928Progesterone Enhanced Remyelination in the Mouse Corpus Callosum After Cuprizone Induced Demyelination507514ENGLISHIrajRagerdi KashaniDepartment of Anatomical Sciences, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. ragerdi@tums.ac.irAzimHedayatpourParichehrPasbakhshLayaKafamiBehzadKhallaghiFatemehMalek2013101920140304Background: Progesterone as a sex steroid hormone is thought to affect and prevent demyelination, but its role in promoting myelin repair is far less investigated. In this study, remyelinating potential of progesterone in corpus callosum was evaluated on an experimental model of MS.Methods: In this experimental study, adult male C57BL/6 mice were fed with 0.2% (w/w) cuprizone in ground breeder chow ad libitum for 6 weeks. At day zero, after cuprizone removal, mice were divided randomly into two groups: (a) placebo group, which received saline pellet implant, (b) progesterone group, which received progesterone pellet implant. Some mice of the same age were fed with their normal diet to serve as the healthy control group. Two weeks after progesterone administration, Myelin content was assessed by Luxol-fast blue staining. The myelin basic protein (MBP) and proteolipid protein (PLP) expression were assessed using Western blot analysis and the changes in the number of oligodendrocytes and oligodendroglial progenitor cells were assessed by immunohistochemistry (IHC) and flow cytometry.Results: Luxol-fast blue staining revealed enhanced remyelination in the progesterone group when compared with the placebo group. Densitometry measurements of immunoblots demonstrated that MBP and PLP proteins contents were significantly increased in the progesterone group compared with the placebo group. Flow cytometry and IHC analysis showed increases in Olig2 and O4 cells in the progesterone group compared with the placebo group.Conclusion: Overall, our results indicate that progesterone treatment can stimulate myelin production and that it may provide a feasible and practical way for remyelination in diseases such as multiple sclerosis.Shiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071640620150928Prevalence of qnr and aac(6’)-Ib-cr Genes in Clinical Isolates of Klebsiella Pneumoniae from Imam Hussein Hospital in Tehran515521ENFereshtehEftekharDepartment of Microbiology, Faculty of Biological Sciences, Shahid Beheshti
University, Tehran, Iran. f-eftekhar@sbu.ac.irSeyed MohsenSeyedpour2013102620140423Background: Plasmid mediated quinolone resistance (PMQR) has been shown to play an important role in resistance not only to quinolones, but also β-lactams and aminoglycosides. In fact, qnr genes are frequently carried along with β-lactamase determinants on the same plasmids. We studied the prevalence of qnrA, qnrB, qnrS and aac(6’)-Ib-cr genes among quinolone and cephalosporin resistant clinical isolates of Klebsiella pneumoniae (K. pneumoniae), as well as the association between PMQR genes with resistance to quinolones, cephalosporins and aminoglycosides.Methods: The study was conducted on 79 K. pneumoniae clinical isolates collected from Imam Hussein hospital in Tehran between July 2010 and January 2011, based on their resistance to quinilones and cephalosporins. Antibacterial susceptibility was determined to 15 antibiotics by disc diffusion. Presence of qnrA, qnrB, qnrS and aac(6’)-Ib-cr genes were investigated using specific primers and PCR.Results: Of the 79 K. pneumoniae isolates, 47 (59.5%) carried the PMQR determinants. Among these, 42 (89.4%) carried aac(6’)-Ib-cr of which, 21 (50%) also harbored qnrB. Three isolates carried qnrB alone, two (4.2%) harbored qnrS and none had qnrA. Resistance to aminoglycosides and cephalosporins was significantly higher in the isolates carrying both qnrB and aac(6’)-Ib-cr genes compared to aac(6’)-Ib-cr alone.Conclusion: This study showed a high prevalence of aac(6’)-Ib-cr and qnrB genes among the Iranian K. pneumoniae clinical isolates as well as co-carriage of the two genes. There was a significant association between qnrB gene carriage and resistance to quinolones, cephalosporins, and aminoglycosides. Shiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071640620150928The Prevalence of Metabolic Syndrome According to Different Criteria and its Associated Factors in Type 2 Diabetic Patients in Kerman, Iran522525ENZohreForoozanfarPhysiology Research Center, Kerman University of Medical Sciences, Kerman, Iran
Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran. foroozan_327@yahoo.comHamidNajafipourNargesKhanjaniAbbasBahrampourHosseinaliEbrahimi201402172014061520140309Metabolic syndrome is highly prevalent in type 2 diabetics and is a strong risk factor for cardiovascular diseases in such patients. The aim of this study was to determine the prevalence of metabolic syndrome according to the three criteria of ATPIII, IDF and the new criteria for metabolic syndrome diagnosis in Kerman, Iran.This cross-sectional study was performed on 950 diabetic type 2 patients. Data was analyzed by independent t-test, chi-square and logistic regression using the SPSS (revision 20) software.The prevalence of metabolic syndrome in Kerman was 73.4, 64.9, and 70.4%, according to the above criteria. Fasting blood sugar, gender, triglyceride, HDL, waist circumference, and systolic blood pressure were related to the prevalence of metabolic syndrome according to the above-mentioned criteria.The prevalence of metabolic syndrome is high in type 2 diabetic patients and the above-mentioned factors exacerbate the situationShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071640620150930Isolation of Methicillin-Resistant Staphylococcus aureus (MRSA) from HIV Patients Referring to HIV Referral Center, Shiraz, Iran, 2011-2012526530ENParvinHassanzadehDepartment of Biology, School of Sciences, Shiraz University, Shiraz, Iran. hassanzadeh@susc.ac.irYashginHassanzadehJalalMardanehEsmaeelRezaiMohammadMotamedifar2014020820140629Extension of drug resistant Staphylococcus aureus strains is one of the problems of modern society. Presence of methicillin-resistant Staphylococcus aureus (MRSA) in HIV-infected individuals is an important cause of severe infections. Therefore, the main goal of this study was to determine the prevalence rate of MRSA carriage rate among HIV patients referring to the Shiraz HIV referral center (Shiraz, Iran) during 2011-2012. Nasal swabs were obtained from HIV positive patients and were cultured on differential and selective media to isolate Staphylococcus aureus, which was confirmed by standard biochemical tests. For isolation of MRSA isolates, bacterial suspensions were cultured on Muller-Hinton Agar containing NaCl and Oxacillin. Finally, data were analyzed by the SPSS software. Of 180 HIV patients, MRSA was isolated from nasal cavity of 23 (12.8%) patients. Most of the isolates were recovered from male subjects who were under 40 years old. No variables such as skin disease, history of hospitalization or infectious disease had significant association with the MRSA colonization rate. The presence of MRSA isolates in the nasal cavity of HIV patients in such a rate warns us about the potential spreading of MRSA among HIV patients in our society and emphasizes on establishing better prevention strategies.Shiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071640620150930Yazd Breast Cancer Project Profile; A Community Based Trial for the Evaluation of Self-Examination and Physical Examination of the Breast Cancer Disease531536ENAnthony BMillerDepartment of Preventive Medicine and Biostatistics, University of Toronto, Toronto, Ontario, Canada. mhlotfi56359@yahoo.comIrajHarrirchiMohammad HassanLotfiMahmoudNooriMohsenMirzaeMajidJafarizadeaMohammad RezaSadeghianMojganMinosepehr2013122720140615There is some evidence to suggest that a benefit might be derived from a program that incorporated both annual physical examination of the breast (BPx) and the teaching of breast self-examination (BSE). Current investigation presents the profile of a multicenter community based intervention for evaluating the effect of BSE+BPx on the reduction of morbidity and mortality due to breast cancer amongst women residing in urban areas of Yazd (Iran) from 2008 to 2018. There were three distinctive phases in this trial with 10 years duration: pilot phase with the duration of 1 year, active intervention phase with 4 rounds of annual screening of BPx+BSE and follow up phase with 5 years duration. Tools of enquiry included a pre-tested questionnaire, repeated annual physical examination of the breast and more importantly mammography, sonography, and fine needle aspiration (FNA). Data were analyzed using descriptive statistics such as frequencies, percent, mean (SD), tests of chi-square and student t-test with 95% confidence level. Comparison of socio-demographic and socio-economic factors such as age, age at marriage, family size, number of live births, occupation, education level, total family income and marital status showed that no significant difference was seen between the groups (P&gt;0.05). A response rate of 84.5% was seen by participants of the experiment group visiting the health centers for the first BPx. Our results showed that except for the education and marital status, the difference in other main demographic and socio-economic factors between the groups were not significant, and the response rate of individuals in the experiment group was at an acceptable level.Shiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071640620150930Spontaneous Unruptured Bilateral Tubal Pregnancy: A Case Report537540ENNayerehGhomianDepartment of Obstetrics and Gynecology, Ovulation Dysfunction Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Ghomiann@mums.ac.irMarziyehLotfalizadeh2013081520141006Bilateral spontaneous tubal ectopic pregnancy is the rarest form of extra uterine pregnancy. The diagnosis is usually made intraoperatively and levels of serum BHCG and ultrasound has not been useful in the diagnosis of bilateral tubal ectopic pregnancy.A 33-year-old woman with 8 weeks amenorrhea and sever lower abdominal pain was admitted. A transvaginal pelvic ultrasound revealed left adnexal mass and massive fluid collection in the pelvis and abdomen. The serum BHCG was 5,700 mIU/ml and in laparotomy bilateral unruptured tubal pregnancy was noted. Left salpingectomy and right salpingostomy were performed.The diagnosis of bilateral spontaneous tubal ectopic pregnancy is usually made intraoperatively. Both tubes at the time of surgery should be closely examined in order to prevent maternal morbidity and mortality.Shiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071640620150930Primary Epidural Varicosis as a Rare Cause of Sciatica: A Case Report541543ENFarzadOmidi-KashaniDepartment of Orthopaedic, Orthopaedic Research Center, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. omidif@mums.ac.irEbrahimGhayem HasankhaniMahdiFathi20130724Non-discogenic sciatica can be caused by any lesion along the course of the lumbosacral nerve roots and sciatic nerve. We aim to present a rare case of refractory sciatica in an otherwise healthy 25-year-old man. He complained of left leg pain without significant back pain. Extensor hallucis longus muscle was weak on the left side with limited straight leg rising. On magnetic resonance imaging, a space-occupying lesion resembling a sequestrated disc was noted that after surgical decompression, epidural varicosis was demonstrated.Shiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071640620151001Bilateral Abducent Palsy in Leptospirosis- An Eye Opener to a Rare Neuro Ocular Manifestation: A Case Report544547ENMahadevaiahMaheshAssociate Professor of Medicine, Department of General Medicine, JSS Medical College, Mysore, Karnataka State, India. doctmahesh@yahoo.comMamathaShivanagappaChilkunda RaviprakashVenkatesh2015100120151001Leptospirosis, a disease of great significance in tropical countries, presents commonly as a biphasic illness with acute febrile episode in the first phase followed by a brief afebrile period and then by the second phase of fever with or without jaundice and renal failure. However, it has varied manifestations and unusual clinical features ascribed to immunological phenomena can occur due to the additional involvement of pulmonary, cardiovascular, and neurological systems. Among the various neurological features, aseptic meningitis is the most common myeloradiculopathy, myelopathy, cerebellar dysfunction, transverse myelitis, Guillain-Barre syndrome, optic neuritis, peripheral neuropathy are also described. Cranial neuropathy involving facial nerve is a rare, but known neurological manifestation. Sixth nerve palsy in neuroleptospirosis has so far not been reported. We hereby present the occurrence of bilateral abducent nerve palsy in a patient with leptospirosis.Shiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071640620151001Efficacy and Safety of Aripiprazole for Treatment of Irritability in Children with Autistic Disorder: An Open-Label Study548549ENNastaranHabibiDepartment of Psychiatry, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. dr_nhabibi@yahoo.comNasrinDodangiAliNazeri20150228Shiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071640620151001Bicornuate Zenker’s Diverticulum550551ENBizhanZiaianDivision of Thoracic Surgery, General Surgery Department, Shiraz University of Medical Sciences, Shiraz, Iran. ziaianb@gmail.comSamMoslemi2015011420150620